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Short-Film Contest Entry Form October 23-24, 2010 - Harrisburg, PA Presented by

Part I. Filmmaker Information First Name:

Last Name:

Address: City:

State:

Phone:

Zipcode:

Pennsylvania Chapter

Email:

Part II. Film Information Title of Film: Length of Film: Tell us a little about your Film:

Theme of Film (Place an “x” next to the category you are submitting under, please choose one): ___ Sustainable Communities ___ Locally & Organically Grown ___ Marcellus Shale Drilling ___ Climate Change in PA Part III (Place an “x” next to the statements below and sign and date this document): ___ I hereby give the film contest permission to place my film on the festival’s and related partners’ web sites as well as screen at the Film Festival. ___ I am fully aware of the rules of the film contest and agree with the conditions. ________________________

____________

_____________________

Print Name

Date

Signature

Questions??? Email: evergreenfilmfest@gmail.com

Short Film Registration Form  

Ever Green Sustainable Film Fest - Short Film Contest Registration Form

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